Clinicopathological Study of 72 Periapical Lesions from Vietnamese Patients

Abstract

OBJECTIVES: This retrospective study evaluated the clinical and histopathological features of 72 periapical lesions in Vietnamese patients. MATERIALS AND METHODS: Seventy- two periapical lesions obtained from 72 patients after periapical surgery due to unsuccessful root canal retreatment of anterior teeth were histologically analyzed and classified as periapical granulomas, periapical cysts, and periapical scars. The demographic data: patient’s age, gender, and lesion sites were also recorded. RESULTS: The mean age was 34.74 years, with a range from 12-65. Of these lesions, 53 cases were found in the maxilla and 19 cases in the mandible. The lesions occurred more frequently in the third to fourth decade of life and the most involved tooth was the lateral incisor. Periapical granulomas accounted for 45 cases (62.5%), followed by periapical cysts with 27 cases (37.5%). Of the 27 periapical cysts, 96.3% of the cases were lined with stratified squamous epithelium and the remaining with respiratory epithelium. The prevalence of cholesterol clefts, foamy histocytes, and dystrophic calcification in the periapical cyst was 22.2%, 29.6%, 25.7%, and 8.8%, 11.1%, 51.1% in the periapical granuloma, respectively. One periapical cyst contained a foreign body (3.7%). Only two periapical granulomas demonstrated mixed acute and chronic inflammation. CONCLUSION: All cases were identified as benign lesions with the most common type being periapical granuloma. The data of this study also confirms the importance of histological examination to establish an accurate diagnosis to eradicate a malignant lesion that may be present in the periapical region of teeth.